Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue

Felice Pecoraro, Mayur Krishnaswamy, Felice Pecoraro, Frank J Veith, Mario Lachat, Gilbert Puippe, Johnny Steuer, Mayur Krishnaswamy, Zoran Rancic, Nicola Mangialardi, Neal S Cayne, Thomas Pfammatter

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: Percutaneous remote access for endovascular aortic repair is an advantageous alternative to open access. Previous surgery in the femoral region and the presence of synthetic vascular grafts in the femoral/iliac arteries represent major limitations to percutaneous remote access. The aim of this study was to evaluate an original technique used for enabling percutaneous remote access for thoracic or abdominal endovascular aortic repair in patients with scar tissue and/or a vascular graft in the groin. Methods: Twenty-five consecutive patients with a thoracic (11/25; 44%) or an aortic aneurysm (14/25; 66%) and with a synthetic vascular graft in the groin (16/25; 64%) or a redo groin access (9/25; 36%) were managed through the percutaneous remote access. In all patients, a percutaneous transluminal angioplasty balloon was used to predilate the scar tissue and the femoral artery or the synthetic vascular graft after preclosing (ProGlide®; Abbott Vascular, Santa Clara, CA, USA). In 10 patients, requiring a 20 Fr sheath, a 6 mm percutaneous transluminal angioplasty balloon was used; and in the remaining 15, requiring a 24 Fr sheath, an 8 mm percutaneous transluminal angioplasty balloon. Preclosing was exclusively performed using ProGlide®. Mean follow-up was 15 months. Results: In all cases, stent-graft deployment was successful. There was one surgical conversion (4%; 1/25) due to bleeding from a femoral anastomosis. Two cases required additional percutaneous maneuvers (postclosing with another system in one patient and endoluminal shielding with stent-graft in the other patient). No pseudoaneurysm or access complication occurred during the follow-up. Conclusions: Percutaneous access in redo groins with scar tissue and/or synthetic vascular graft using ultrasound-guided punction, preclosing with ProGlide® system and predilation with percutaneous transluminal angioplasty balloon to introduce large size sheath as used for endovascular aortic repair showed to be feasible, safe and with few local complications.
Original languageEnglish
Pages (from-to)396-401
Number of pages6
JournalVascular
Volume25
Publication statusPublished - 2017

All Science Journal Classification (ASJC) codes

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue'. Together they form a unique fingerprint.

  • Cite this

    Pecoraro, F., Krishnaswamy, M., Pecoraro, F., Veith, F. J., Lachat, M., Puippe, G., Steuer, J., Krishnaswamy, M., Rancic, Z., Mangialardi, N., Cayne, N. S., & Pfammatter, T. (2017). Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue. Vascular, 25, 396-401.